原发性高血压患者颈动脉粥样硬化与中医证型的关系

目的:探讨原发性高血压患者颈动脉粥样硬化程度与中医辨证分型的关系。方法:用高频(11.4 MHz)彩色多普勒超声检测了130例原发性高血压及心脑血管并发症患者的颈动脉,与37例非高血压心脑血管病患者作对照。结果:高血压各组颈动脉内中膜厚度及斑块检出率均高于对照组,以合并脑血管疾病组内中膜厚度高于单纯高血压组。高血压中医证型之间比较,以痰湿壅盛型内中膜厚度明显高于其他证型,斑块检出率以阴虚阳亢和痰湿壅盛型明显高于其他证型。结论:高血压是引起颈动脉内中膜厚度增加的重要因素。颈动脉粥样硬化程度可作为预测心脑血管病存在的参考指标。动脉硬化的病因病机与痰、瘀密切相关。

The Relationship Between the Carotid Atherosclerosis and the Syndrome Type of Traditional Chinese Medicine in Primary Hypertension

Objective: To study the relationship between the Carotid atherosclerosis and the syndrome type of traditional Chinese medicine(TCM) in primary hypertension.Method: High frequency colordoppler ultrasonography of carotid arteries were used to exam 130 cases of primary hypertension,including with cerebrovascular and coronary artery disease.Thirty-scren cases of normotensives with cardiocerebrovascular diseases were used as control group.Result: The carotid intima-media thickenss and the rates of carotid athermomatous plaques in primary hypertension were higher than those in control group.Those in hypertension with cerebrovascular disease group were higher than those in hypertension group.Among TCM syndrome types in primary hypertension,the carotid intima-media thickness was obviously higher in the phlegm stagnation type than that in other types,the rates of carotid athermomatous plaques was significantly higher in the deficiency of Yin leading to hyperactivity of Yang type and phlegm stagnation type than that in other types.Conclusion: Hypertension is an important factor of causing the increase of the carotid intima-media thickenss.The degree of the carotid atherosclerosis can be the referenced index of anticipating the existence of cardiovascular disease and cerebrovascular disease.The etiology and pathogensis of atherosclerosis have a close relationship with phlegm and haemostasis.